Are novel non-invasive imaging techniques needed in patients with suspected prosthetic heart valve endocarditis? A systematic review and meta-analysis.
Eur Radiol
; 25(7): 2125-33, 2015 Jul.
Article
em En
| MEDLINE
| ID: mdl-25680715
ABSTRACT
OBJECTIVES:
Multimodal non-invasive imaging plays a key role in establishing a diagnosis of PHV endocarditis. The objective of this study was to provide a systematic review of the literature and meta-analysis of the diagnostic accuracy of TTE, TEE, and MDCT in patients with (suspected) PHV endocarditis.METHODS:
Studies published between 1985 and 2013 were identified via search and cross-reference of PubMed/Embase databases. Studies were included if (1) they reported on the non-invasive index tests TTE, TEE, or MDCT; (2) data was provided on PHV endocarditis as the condition of interest; and (3) imaging results were verified against either surgical inspection/autopsy or clinical follow-up reference standards, thereby enabling the extraction of 2-by-2 tables.RESULTS:
Twenty articles (including 496 patients) met the inclusion criteria for PHV endocarditis. TTE, TEE, and MDCT + TEE had a pooled sensitivity/specificity for vegetations of 29/100%; 82/95%, and 88/94%, respectively. The pooled sensitivity/specificity of TTE, TEE, and MDCT + TEE for periannular complications was 36/93%, 86/98%, and 100/94%, respectively.CONCLUSIONS:
TEE showed good sensitivity and specificity for establishing a diagnosis of PHV endocarditis. Although MDCT data are limited, this review showed that MDCT in addition to TEE may improve sensitivity in detecting life-threatening periannular complications. KEY POINTS ⢠Multimodal imaging is an important ingredient of diagnostic workup for PHV endocarditis. ⢠Transthoracic and transesophageal echography may miss life-threatening periannular complications. ⢠MDCT can improve sensitivity for the detection of life-threatening periannular complications.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Próteses Valvulares Cardíacas
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Infecções Relacionadas à Prótese
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Endocardite
Tipo de estudo:
Diagnostic_studies
/
Guideline
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Prognostic_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article